Immunophenotyping and Minimal Residual Disease in Palestinian children under 15 with Acute Lymphoblastic Leukemia: A Retrospective Study from Beit Jala Governmental Hospital رسالة ماجستير

Abstract

Leukemia is an abnormality of many blood cells because of a defect in bone marrow. It influences mostly elderly people aged 55 years and above but it is also a known cancer in children less than 15 years. The main goal of this research is to test the Minimal Residual Disease (MRD) at the day 33 after treatment. MRD is a test that detects the existence of leukemic cells (B-cells, T-cells, and precursor B-cells) remain in a blood of patient and classified as a main reason of relapse in leukemia, and could be a significant effect in specifying the protocol of treatment. Goal This study defines the dominant immunoglobulin markers among targeted patients and examined white blood cells count, hemoglobin, and platelets count. The method used in this research is to detect minimal residual disease was a flow cytometry with eight colors. This quantitative descriptive design approach retrospective study focused on a common cancer for pediatric which was childhood acute lymphoblastic leukemia. The main goal of this research is to test the Minimal Residual Disease (MRD) after treatment at the day 33. The MRD is a test that detects the existence of leukemic cells (B-cells, T-cells, and precursor B-cells) remain in a blood of patient and classified as a main reason of relapse in leukemia Study population It targeted 84 patients; 44 males and 40 females. Their data were collected from medical records stored in Beit Jala hospital. Samples were taken in Beit Jala hospital and sent to King Husein Cancer Center in Jordan, and King Hussein Cancer Center sent back reports to our hospital. VII Results This study results showed that MRD tested positive in 18 patients with 21.4%from the total population. MRD was positive in 11.8% patients who had B-cells, 6% patients in precursor B-cells, and 3.6% patients with T-cells. The B-cell appeared in 54.8%, precursor B-cell constituted 27.4%, and T-cell showed in 16.6%, and one patient with down syndrome diagnosed as B-cell with 1.2%.It is also shown that some markers such as CD10, CD34, CD20 (P), CD38, CD58, and CD19 can play a primary role from both diagnostic and prognosis point of view linked to pediatric cancer and therefore a better treatment protocols and more lives saving. The CD10 found in 53.6% of patients in our study are as follows: 37% in B-cells and 16.6% in precursor B-cells. The CD34 are shown in about quarter of patients under research (26%), 16.5% in B-cells and 9.5% in precursor B-cells respectively. The results of CD20 (P) found in 29% of patients’ files examined in our research are as follows: 23% in B-cells and 6% in precursor B-cells. The CD58 are found in 44% of patients; 27.4% in B-cells and 13% in precursor B-cells, whereas 2.4% in T-cells. The CD38 was appeared in 32% of patients; 24% in B-cells and 8% in precursor B-cells respectively. The CD19 found in our study is 54% of which a 37% is present in B-cells and 15.5% in precursor B-cells respectively. The markerCD7 was found positive in 6% of patients with T-cells and zero percent in patients with B-cells. As shown from our findings most of the markers were associated with either B-cells or precursor B-cells, and CD7 can consider as a marker of T-cell although its percentage was low.